Researchers are using artificial intelligence (AI) to uncover why some oestrogen receptor (ER) positive breast cancers can reappear many years after treatment, in two pioneering research projects backed by £800,000 of funding from Breast Cancer Now.
Around 44,000 women are diagnosed with ER-positive disease each year in the UK, making up around 80% of all breast cancer diagnoses.
Most breast cancers don’t return after treatment. But for some, breast cancer cells quietly survive in the body for decades. They stay inactive, or dormant, until one day they “wake up” and start growing again, often leading to a shock diagnosis of incurable metastatic breast cancer.
Understanding why some breast cancer cells become dormant and what causes them to wake up years later is one of the biggest challenges in breast cancer research.
By harnessing AI, researchers can analyse both clinical and cancer cell data at a scale and level of detail that would otherwise be impossible, hoping to uncover patterns that reveal which breast cancers are most likely to return. This could ultimately pave the way for more personalised treatment, earlier intervention and fewer people facing an incurable diagnosis.
Professor Maria Secrier from University College London, in collaboration with Professor Luca Magnani’s lab at the Breast Cancer Now Toby Robins Research Centre at The Institute of Cancer Research, London, will use the Breast Cancer Now funding to study how ER-positive breast cancer cells enter, stay in, and exist in this dormant state.
The researchers aim to map molecular changes that allow breast cancer cells to become inactive. And they’re developing advanced AI models trained on large amounts of data collected from cancer cells as they undergo treatment.
These models can learn the patterns and “rules” that cancer cells follow, including how they become dormant and what causes them to become active again.
The team is also studying how dormant cancer cells interact with nearby immune cells, blood vessels and connective tissue and how these can help or hinder inactive breast cancer cells.
Using this information, they want to identify when cancer cells are likely to “wake up”, so they can predict which breast cancers may recur.
Professor Maria Secrier from University College London said: “The challenge of understanding why some ER-positive breast cancers come back after many years is not a lack of data, but a lack of innovative tools to study the data. So we’re combining cutting-edge AI with our biology expertise to find ways to predict, and stop, ER-positive breast cancer returning.”
Dr Maggie Cheang and her team at The Institute of Cancer Research (ICR) will use the Breast Cancer Now funding to study tumour samples from people with ER-positive breast cancer who took part in the POETIC clinical trial* (funded by Cancer Research UK) which followed them for more than 10 years after surgery.
POETIC collected tumour samples before treatment, while patients were receiving therapy, and samples from cancers that had come back after treatment. Using advanced imaging and molecular techniques, they will study how cancer cells are organised, how they interact with their surroundings and identify breast cancer cells that survive treatment.
The team will then use AI and computational approaches to analyse the large amounts of data and look for patterns that could reveal the earliest signs – within two weeks of diagnosis - that cancer is becoming resistant to treatment or is more likely to return later.
They hope to identify important biological differences that will help them to understand how treatment resistance begins. In the future, this could give doctors the practical tools to estimate someone’s risk of recurrence and provide tailored follow-up care.
Dr Maggie Cheang from The Institute of Cancer Research London, said: “Late relapse can feel unpredictable and frightening. We want to change that. By combining detailed imaging, molecular and clinical trial data with the power of AI, we can study tumours in much greater detail and find patterns that would be impossible to see otherwise. We hope this will help us spot risk earlier, guide better treatment and give people more confidence about the future.”
Dr Simon Vincent, chief scientific officer at Breast Cancer Now, said:
“Living with the fear of breast cancer returning can be all-consuming. People can spend years worrying about every ache or pain, without knowing what the future holds. We want to change that, so people live well and without fear beyond a breast cancer treatment.
“We’re proud to be investing in innovative research using the power of AI, driving progress in helping to uncover why some breast cancer returns many years later and spot the early warning signs. These projects could help develop tools to identify who is most at risk of recurrence, helping doctors to tailor follow-up care and ultimately ensure fewer people die from this devastating disease."
Katharine Williams from Birmingham was diagnosed with breast cancer aged, 43.
Katharine says: “Thankfully it was caught early but it turned my world upside-down overnight. Suddenly I had all these appointments and tests, but luckily it had not spread to any of my lymph nodes.”
Katharine had a lumpectomy in February 2024, followed by four weeks of radiotherapy in April and May. As her cancer was oestrogen receptor (ER) positive, she is now taking tamoxifen, which she will continue for five years to help reduce the risk of the cancer returning in the same breast or spreading somewhere else in the body.
Katharine is supporting this new research as the risk of breast cancer recurrence remains a concern for her.
Katharine says: “Recurrence is something that anyone who has had breast cancer thinks about. My medical team has said my chance of recurrence is low because the cancer hadn’t spread to my lymph nodes, but it’s still something that crosses my mind regularly. I have good days and bad days with it, but mostly I try to stay positive, get on with work and stay healthy.
“Having breast cancer changes your life forever, and this research gives me hope that we could one day understand who is most at risk and find better ways to prevent recurrence. For those of us living with this uncertainty, that could make an enormous difference.”
“It could also mean that we can make more informed decisions about the relative benefits of treatments, such as tamoxifen. These treatments often cause difficult side effects which many women, including myself, find challenging to manage”.
ENDS
For more information or to arrange an interview, please contact the Breast Cancer Now press office at press@breastcancernow.org or on 07436 107914.
Notes to Editors
Breast Cancer Now would like to thank Art for Cure for their generous support of Professor Maria Secrier's research.
*POETIC trial - Funded by Cancer Research UK, POETIC is managed by the Clinical Trials and Statistics Unit at the ICR and has follow-up for more than 10 years after surgery. This creates a uniquely valuable resource for understanding why some breast cancers return. Dr Cheang is the current Translational Lead for the trial.
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